The COX-2 inhibitors: a reasoned review of the data

The recent press coverage of the issues surrounding non steroidal anti-inflammatory drugs and the selective COX-2 inhibitors has not allowed for an informed debate to take place regarding the therapeutic risk to benefit ratio of these drugs. The overall discussions that have taken place within the context of the regulatory decision process has been mostly proprietary and thus not made public and the resultant decisions have not been prominently featured in the popular press so have not gotten the attention of the practicing clinician or the patients who use these drugs. This paper will review the evidence that has been accumulated and highlight the decisions that have been made by some of the regulatory groups to address the issues surrounding overall benefit to risk of the NSAIDs inclusive the COX-2 selective inhibitors.